Hearing loss in the aged

Abstract

Hearing loss is now one of the chronic diseases with the most impact on quality of life of aged Chinese people. According to the second China National Sample Survey on Disability there are 15,400,000 people over 60 years of age suffering from a hearing disorder. Among these, 2,788,600 have more than a severe hearing loss. The main causes of hearing loss in Chinese elderly people are presbycusis, long-term exposure to noise, otitis media and systematic diseases. Hearing thresholds increase approximately 10dB per decade for subjects aged 60 years and above, and remain stable from 50 to 70 years of age. A dramatic increase occurs after 70 years of age. Speech recognition showed a poor correlation with pure tone thresholds in patients older than 80 years, suggesting that the age factor should be taken into account when considering hearing amplification. The auditory brainstem response (ABR) and mismatch negativity (MMN) response have demonstrated both peripheral and central deterioration of hearing pathways in elderly people. Use of a hearing aid is the main approach for helping elderly people overcome difficulties in communication. In the past 10 years, digital hearing aids have gradually replaced analogue ones in China and have been shown to have a better effect. However, compared with the proportion of aged people with hearing loss in China, the number of those who use hearing aids is very small. This may be related to the following factors: 1) a traditional attitude towards hearing loss in the elderly; 2) financial reasons; 3) some worries due to the unfamiliarity of hearing aids; and 4) inability to manipulate hearing aids. The main complaints in elderly hearing aid users include self-hearing being too loud, a muffled feeling, excessive gain in the higher frequencies and poor speech recognition. Cochlear implants have also been used in pre-elderly and elderly patients in China. At present there is a long way to go in developing hearing healthcare services for elderly people in China. It is necessary to provide more hearing training and rehabilitation for elderly people with hearing loss using various means.

Sensory Loss in China: Prevalence, Use of Aids, and Impacts on Social Participation

“…Although self-reported vision problems are common in China, particularly rural China, there is comparatively limited use of glasses due to poverty, misinformation, and mistaken views (for example that wearing glasses leads to further loss of vision) (21, 22). Similarly, there is less uptake of hearing aid use than expected for the large number of people in China with hearing loss (23). Reasons posited by these authors for poor uptake of hearing aids include traditional attitudes toward hearing loss in older people (“it is a normal part of aging”), financial constraints, unfamiliarity with hearing aids, and difficulty manipulating hearing aids.…”

<p>Preferences for Hearing Aid Attributes Among People with Moderate or Greater Hearing Loss in Rural China: A Discrete Choice Experiment</p>

“…In addition, replacing the battery is a relatively complex operation since its small size makes it difficult to operate, especially for older persons or patients with physical problems. 24 Further, batteries are the ongoing cost after paying for the hearing aid itself. For these reasons, rural individuals in China may weigh more on battery life compared to people living in urban areas or more developed countries.…”

“…The main challenges of underuse of hearing aids in China are the lack of trained audiologists to provide rehabilitation, the absence of a supportive culture for hearing aid use and concern about the cost of hearing aid devices. [23][24][25] In China, audiology is a relatively new profession, with only a 10 to 20-year history, and there are only about 1200 audiologists to provide audiological services, primarily located in urban areas. 25 Chinese speakers do not seem to note a significant communication challenge until the hearing loss in the better ear reaches 40 dB HL or worse, and many Chinese older people view hearing loss as part of the aging process, which discourages any intervention.…”

“…25 Chinese speakers do not seem to note a significant communication challenge until the hearing loss in the better ear reaches 40 dB HL or worse, and many Chinese older people view hearing loss as part of the aging process, which discourages any intervention. 24 In China, there is almost no social insurance coverage for hearing aids, and patients pay out-of-pocket for hearing device. 24,26 With the implementation of "Guidance on Medical Rehabilitation for the 13th Five-Year Plan (2016)" and "Healthy China Initiative 2019 to 2030", investment in rehabilitation services is scheduled to increase dramatically, and knowledge of the factors that affect hearing aid preferences and willingness to pay (WTP) for hearing aids contributes to understanding these government initiatives.…”

Cognitive reserve regulates the association between hearing difficulties and incident cognitive impairment evidence from a longitudinal study in China

“…More than 40% of the Chinese elderly population develop cognitive impairment (Hu et al, 2018). Similarly, 34.59% of the elderly suffer from hearing impairment in China (Ji et al, 2015). In addition to its prevalence, individuals with hearing difficulties typically display poor cognitive performance.…”